股骨粗隆部骨折手术治疗成功与失败的分析

Analysis of success and failure of intertrochanteric fracture of the femur

目的:探讨股骨粗隆部骨折后手术内固定治疗(以动力髋螺钉髓外固定为例)成功与失败的原因。方法:收治行动力髋螺钉手术内固定治疗的股骨粗隆骨折患者54例,对其临床资料进行回顾性分析,总结并分析股骨粗隆部骨折后手术内固定治疗成功与失败的经验。结果:术后随访6~32个月,平均1年,其中有9例患者出现程度不同的并发症:1例感染,3例内固定失败(1例松动、1例断钉、1例顶部螺钉穿出),2例骨折不愈合或延迟,2例髋内翻短缩。结论:导致股骨粗隆部骨折后手术内固定治疗失败的原因可能与病例选择不当、术中复位不佳、髋螺钉的位置不佳、钢板长度不够等有关,术前应充分做好准备,以提高手术治疗的成功率。

Objective:To investigate success and failure reasons of internal fixation operation after the intertrochanteric fracture of the femur(with dynamic hip screw extramedullary fixation for example).Methods:To admit 54 cases of patients with intertrochanteric fracture of the femur,and with the treatment of dynamic hip screw internal fixation operation from June 2010 to June 2013.The clinical data were analyzed retrospectively,summarize and analyze the success and failure experience of internal fixation operation after the intertrochanteric fracture of the femur.Results:Patients were followed up for 6~32 months,an average of 1 year,including 9 patients with different degree complications:1 case of infection,3 cases of internal fixation failure(1 case of loose,1 case of broken nail,1 case of the top screw out),2 cases of fracture nonunion or delayed,2 cases of coxa vara shortening. Conclusion:Cause of internal fixation operation treatment after the intertrochanteric fracture of the femur failure may be due to improper patient selection,intraoperative redution and hip screw position are poor,the length of the plate is not relevant,sufficient preoperative preparation,in order to improve the success rate of operation treatment.